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Page 2 of 5 For adults, a short course (usually three days) of a strong topical steroid may be an option to treat a mild-tomoderate flare-up of eczema. A strong topical steroid often works quicker than a mild one. (This is in contrast to the traditional method of using the lowest strength wherever possible. However, studies have shown that using a high strength for a short period can be more convenient and is thought to be safe.)
Area of skin to be treated (adults) Ahand and fingers (front and back) Front of chest and abdomen Back and buttocks Face and neck An entire arm and hand An entire leg and foot
Size is roughly About 2 adult hands About 14 adult hands About 14 adult hands About 5 adult hands About 8 adult hands About 16 adult hands
FTUs each dose (adults) 1 FTU 7 FTUs 7 FTUs 2.5 FTUs 4 FTUs 8 FTUs
Page 3 of 5 An FTU of cream or ointment is measured on an adult index finger before being rubbed on to a child. Again, one FTU is used to treat an area of skin on a child, equivalent to twice the size of the flat of an adult's hand with the fingers together. You can gauge the amount of topical steroid to use by using your (adult) hand to measure the amount of skin affected on the child. From this you can work out the amount of topical steroid to use.
The following gives a rough guide: For a 3-6 month-old child: Entire face and neck - 1 FTU. An entire arm and hand - 1 FTU. An entire leg and foot - 1.5 FTUs. The entire front of chest and abdomen - 1 FTU. The entire back including buttocks - 1.5 FTUs. For a 1-2 year-old child: Entire face and neck - 1.5 FTUs. An entire arm and hand - 1.5 FTUs. An entire leg and foot - 2 FTUs. The entire front of chest and abdomen - 2 FTUs. The entire back including buttocks - 3 FTUs. For a 3-5 year-old child: Entire face and neck - 1.5 FTUs. An entire arm and hand - 2 FTUs. An entire leg and foot - 3 FTUs. The entire front of chest and abdomen - 3 FTUs. The entire back including buttocks - 3.5 FTUs. For a 6-10 year-old child: Entire face and neck - 2 FTUs. An entire arm and hand - 2.5 FTUs. An entire leg and foot - 4.5 FTUs. The entire front of chest and abdomen - 3.5 FTUs. The entire back including buttocks - 5 FTUs.
Page 4 of 5 Topical steroids may trigger or worsen other skin disorders such as acne, rosacea and perioral dermatitis. Some topical steroid gets through the skin and into the bloodstream. The amount is usually small and usually causes no problems unless strong topical steroids are used regularly on large areas of the skin. The main concern is with children who need frequent courses of strong topical steroids. The steroid can have an effect on growth. Therefore, children who need repeated courses of strong topical steroids should have their growth monitored.
Occasionally, some people become sensitised (allergic) to an ingredient in a topical cream (such as a preservative). This can make the skin inflammation worse rather than better. A leaflet comes with each topical steroid and gives a full list of possible side-effects.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical
conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Original Author: Dr Tim Kenny Last Checked: 21/02/2012 Current Version: Dr Laurence Knott Document ID: 4853 Version: 42 Peer Reviewer: Dr Tim Kenny EMIS
View this article online at www.patient.co.uk/health/Topical-Steroids-for-Eczema.htm. Discuss Topical Steroids for Eczema and find more trusted resources at www.patient.co.uk.
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